A smart micro-drill for cochleostomy formation: a comparison of cochlear disturbances with manual drilling and a human trial

Coulson, C. J. and Zoka Assadi, M. and Taylor, R. P. and Du, X. and Brett, P. N. and Reid, A. P. and Proops, D. W. (2013) A smart micro-drill for cochleostomy formation: a comparison of cochlear disturbances with manual drilling and a human trial. Cochlear Implants International, 14 (2). pp. 98-106. ISSN 1467-0100


Background: Cochleostomy formation is a key stage of the cochlear implantation procedure. Minimizing the trauma sustained by the cochlea during this step is thought to be a critical feature in hearing preservation cochlear implantation. The aim of this paper is firstly, to assess the cochlea disturbances during manual and robotic cochleostomy formation. Secondly, to determine whether the use of a smart micro-drill is feasible during human cochlear implantation. Materials and methods: The disturbances within the cochlea during cochleostomy formation were analysed in a porcine specimen by creating a third window cochleostomy, preserving the underlying endosteal membrane, on the anterior aspect of the basal turn of the cochlea. A laser vibrometer was aimed at this third window, to assess its movement while a traditional cochleostomy was performed. Six cochleostomies were performed in total, three manually and three with a smart micro-drill. The mean and peak membrane movement was calculated for both manual and smart micro-drill arms, to represent the disturbances sustained within cochlea during cochleostomy formation. The smart micro-drill was further used to perform live human robotic cochleostomies on three adult patients who met the National Institute of Health and Clinical Excellence criteria for undergoing cochlear implantation. Results: In the porcine trial, the smart micro-drill preserved the endosteal membrane in all three cases. The velocity of movement of the endosteal membrane during manual cochleostomy is approximately 20 times higher on average and 100 times greater in peak velocity, than for robotic cochleostomy. The robot was safely utilized in theatre in all three cases and successfully created a bony cochleostomy while preserving the underlying endosteal membrane. Conclusions: Our experiments have revealed that controlling the force of drilling during cochleostomy formation and opening the endosteal membrane with a pick will minimize the trauma sustained by the cochlea by a factor of 20. Additionally, the smart micro-drill can safely perform a bony cochleostomy in humans under operative conditions and preserve the integrity of the underlying endosteal membrane.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Files associated with this item cannot be displayed due to copyright restrictions.
Faculty/School / Institute/Centre: No Faculty
Faculty/School / Institute/Centre: No Faculty
Date Deposited: 12 Jun 2017 23:44
Last Modified: 13 Jul 2017 05:07
Uncontrolled Keywords: cochlear implant; cochleostomy; laser vibrometer; robot surgery
Fields of Research (2008): 09 Engineering > 0903 Biomedical Engineering > 090304 Medical Devices
Fields of Research (2020): 40 ENGINEERING > 4003 Biomedical engineering > 400308 Medical devices
Socio-Economic Objectives (2008): E Expanding Knowledge > 97 Expanding Knowledge > 970109 Expanding Knowledge in Engineering
Identification Number or DOI: https://doi.org/10.1179/1754762811Y.0000000018
URI: http://eprints.usq.edu.au/id/eprint/31534

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